RT Journal Article
SR Electronic
T1 Critical social framework on the determinants of primary healthcare access and utilisation
JF Family Medicine and Community Health
JO Fam Med Com Health
FD BMJ Publishing Group Ltd
SP e001031
DO 10.1136/fmch-2021-001031
VO 9
IS Suppl 1
A1 Mohammad Hamiduzzaman
A1 Anita De-Bellis
A1 Wendy Abigail
A1 Amber Fletcher
YR 2021
UL http://fmch.bmj.com/content/9/Suppl_1/e001031.abstract
AB This paper aims to contextualise ‘healthcare access and utilisation’ within its wider social circumstances, including structural factors that shape primary healthcare for marginalised groups. Mainstream theories often neglect complexities among the broader social, institutional and cultural milieus that shape primary healthcare utilisation in reality. A blended critical social framework is presented to highlight the recognition and emancipatory intents surrounding person, family, healthcare practice and society. Using the theoretical contributions of Habermas and Honneth, the framework focuses on power relationships, misrecognition/recognition strategies, as well as disempowerment/empowerment dynamics. To enable causal and structural analysis, we draw on the depth ontology of critical realism. The framework is then applied to the case of rural elderly women’s primary healthcare use in Bangladesh. Drawing on the literature, this article illustrates how a blended critical social perspective reveals the overlapping and complex determinants that affect primary healthcare utilisation, before concluding with the importance of situating healthcare access in sociocultural structures.All data relevant to the study are included in the article.